Syncope is the medical word for fainting or passing out caused by a drop in blood pressure. It is common in older children and teens. The reason typically is a temporary lack of oxygen-rich blood reaching the brain. The decreased blood flow to the brain can have a range of causes, most of them harmless. However, sometimes syncope in children can be a symptom of a serious heart condition.
The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, have the experience and skills to diagnose the cause of syncope in children and provide care for any underlying heart condition.
Norton Children’s has a network of outreach diagnostic and treatment services conveniently located throughout Kentucky and Southern Indiana.
Symptoms of Syncope in Children
Depending on what causes a child to faint, these are some common symptoms of syncope that could happen before loss of consciousness:
- Pale or bluish cast to the skin
- Blurred vision or seeing spots
- Feeling weak
- Feeling like the room is spinning or moving
- Incontinence (involuntary urination or defecation)
- Nausea or vomiting
- Ringing in the ears (tinnitus)
- Shortness of breath
- Tingling or numbness in the fingertips and around lips
Why Syncope Happens
Fainting or syncope in otherwise healthy children does not automatically mean a heart condition is to blame. However, even harmless loss of consciousness can cause problems. A child can get hurt during a fall after fainting or stop playing sports due to worry over fainting.
The most common reason a healthy child or teen may be dizzy or faint when standing is that the nervous system gets its signals crossed and doesn’t coordinate the blood vessels and heart like it should. In some people, this cross-firing may be triggered by things such as:
- Extreme emotions
- Having blood drawn
- Hot shower
- Physical strain
- Sight of blood
- Sudden position changes
- Vision changes after standing for a long time
When not related to a heart condition, syncope also may be called:
- Benign or simple faint
- Neurocardiogenic syncope
- Orthostatic intolerance
- Vasomotor instability
- Vasovagal syncope
Most people who have these types of syncope don’t get dizzy or pass out every single time they experience a trigger. Instead, they often have good days (when they have minimal symptoms) and bad days (when they have more dizziness, fatigue, fainting and afternoon headaches).
Numerous kinds of congenital heart defects can cause syncope, including those that interfere with normal contractions or pumping of the heart, such as:
Conditions in which a normal heart rhythm is disrupted can cause children to faint as well, including:
Diagnosing Syncope in Children
Your pediatrician may refer your child to the specialists at Norton Children’s Heart Institute if there is a family history of congenital heart disease, inherited arrhythmia or cardiomyopathy. Or your child may be referred to a pediatric cardiologist due to:
- Existence of a known heart, neurological or other medical condition
- Fainting during active play or sports
- Sudden fainting without any warning or trigger
- Fainting accompanied by chest pain, difficulty breathing or heart palpitations
- Fainting followed by bodily injury, seizure, tongue-biting or urinary incontinence
- Fainting in a child age 8 or younger
- Finding abnormal heartbeats or heart murmur during an exam
During an appointment with a Norton Children’s Heart Institute cardiologist, the physician will:
- Take a careful health history (including details of what happens before, during and after the child faints)
- Perform a careful physical exam
- Order tests that can help confirm or rule out serious conditions
Tests may include:
- Blood work and urine analysis: These tests can look for infections or conditions, such as anemia, that can cause or play a part in fainting.
- Echocardiogram (echo): This test uses sound waves (ultrasound) to produce images of the heart and blood vessels’ structures on a screen. It can show the structure and function of the heart. Norton Children’s Heart Institute has 28 tele-echo locations throughout Kentucky and Southern Indiana.
- Electrocardiogram (ECG or EKG): This test checks the heart’s electrical activity to show damage or irregular rhythms.
- Holter monitor: A Holter monitor records the electrical activity of the child’s heart for 24 hours or longer to help identify a heart condition.
- Magnetic resonance imaging (MRI): A powerful magnet, radio waves and computer create a picture of the heart or other parts of the body.
Syncope not related to a heart condition usually can be treated by paying close attention to triggers, proper nutrition and behavior. Suggested treatments to improve symptoms and reduce the chance of future episodes may include:
- Not skipping meals
- Identifying and avoiding triggers: For example, if the child feels dizzy and it progresses, a faint may be coming soon. The child should sit down or lie down until the dizziness passes. Some people have fewer symptoms by avoiding long, hot showers first thing in the morning. Children can take shorter and cooler showers after supper the night before when they’ve had plenty to eat and drink all day long.
- Increase fluid intake: We often recommend a teenager drink at least two 12-ounce glasses of noncaffeinated beverage at breakfast, lunch and supper, and try to drink even more between meals.
- Increase salt in the diet (sodium, not potassium): Salt helps the body hold onto fluids. Note: Increasing salt may not be a good idea for children with pre-existing high blood pressure, heart failure or kidney disease.
- Regular exercise (focus on the legs): Exercise helps the body’s ability to handle blood flow to the brain when you’re standing up.
Children who continue to have symptoms after these treatments may benefit from one or more medications (for example, fludrocortisone, midodrine, beta blockers or selective serotonin reuptake inhibitors [SSRI] agents). The good news is that this condition is usually temporary. Most children and teens eventually outgrow it.
Children who have syncope due to a congenital heart defect or disease will need treatment based on their specific heart condition. The Norton Children’s Heart Institute team can help develop a treatment plan that is unique for each child, which may include treatments such as catheter ablation, placement of a pacemaker or cardioverter-defibrillator, or heart surgery.
Why Choose Norton Children’s Heart Institute
- Norton Children’s Hospital has been a pioneer in pediatric cardiothoracic surgery, performing Kentucky’s first pediatric heart transplant in 1986 and becoming the second site in the United States to perform an infant heart transplant.
- The American Board of Thoracic Surgery has certified our cardiothoracic surgeons in congenital heart surgery.
- The Adult Congenital Heart Association has accredited Norton Children’s Heart Institute’s Adult Congenital Heart Program as the only comprehensive care center in Kentucky and Indiana treating adults born with a heart defect.
- More than 5,000 children a year visit Norton Children’s Heart Institute for advanced heart care.
- Norton Children’s Heart Institute has offices across Kentucky and Southern Indiana to bring quality pediatric heart care closer to home.
- The Jennifer Lawrence Cardiac Intensive Care Unit (CICU) at Norton Children’s Hospital is the largest dedicated CICU in Kentucky, equipped with 17 private rooms and the newest technology available for heart care.